Trailblazing Kids Desensitize to Dairy Allergy

The therapy may not work for everybody, but an initial 70 per cent success rate is nothing to sneeze at, Carr says. “If we were only successful in one out of 10, that’s still good. That’s turning off the allergy in one person who otherwise is still allergic to that food.”

Although Carr emphasizes that desensitization treatments are in their infancy, he finds the early patient success stories inspiring. Oral immunotherapy experiments are going on around the world with allergens ranging from peanuts to eggs and some tree nuts. The allergist finds milk particularly appealing for desensitization – it’s easy to dilute and measure precisely. But beyond that, tolerance greatly improves quality of life, since dairy ingredients are so common.

Carr is seeing children from all over Alberta with this program. To be eligible, a patient has to be able to make it to his office or another approved, controlled environment every four weeks so that the consumption of a milk dose can be medically supervised. The Edmonton allergists are enrolling children who are school-age and who have a convincing reaction during an initial oral challenge. (A recent anaphylactic reaction is adequate in some cases.)

After the first challenge session, desensitization under an allergist’s care works like this:

In the first phase at home, parents make up a 1-to-25 part dilution of milk. With an eyedropper, a parent puts one drop of that solution on the child’s tongue. That’s done daily for a week. (Many patients take the first dose in the allergist’s office.)

Assuming there are no serious symptoms, the dose increases to two drops by Day 7, and doubles every week for five weeks. By Day 49, the child is switched from the solution to five drops of undiluted milk. Those doses double weekly until the six-month mark, when the child drinks 200 millilitres of milk daily.

If this goes well, he (or she) starts eating other dairy products. The child also takes an antihistamine daily to help the treatment work and to minimize side effects. If reactions persist, families are told to slow down the dose increases.